What is the reason for the low average volume of red blood cells?

One of the results of a routine blood test is a reference value for the average red blood cell volume. If it is not within the normal range, it is said that the average red blood cell volume is too high or too low. Usually, the average red blood cell volume is too low. So if the test results show that the average red blood cell volume is low, will it be harmful to our body? What factors cause the low average red blood cell volume? In fact, the most common reason for a low average red blood cell volume is anemia. Let’s take a detailed look at it below.

Mean red blood cell, what is the mean red blood cell, what is its normal index value, if the mean red blood cell in the human body is too low, what impact will it have on the body, what factors cause its index value to be too low? Let the editor take everyone to take a look!

In addition to using hemoglobin as an indicator to judge anemia, the mean corpuscular hemoglobin concentration must also refer to the number of red blood cells. If the ratio of the two is unbalanced, it is necessary to further refer to the mean corpuscular volume, mean corpuscular hemoglobin amount, mean corpuscular hemoglobin concentration and red blood cell volume distribution width. Anemia caused by different causes can cause changes in the morphology of red blood cells. Examining the morphological characteristics of red blood cells can assist clinicians in finding the cause.

The low average volume of red blood cells indicates that you are prone to iron deficiency. Your hematopoietic organs are able to produce enough red blood cells, but one of the raw materials provided by your food is insufficient, which is iron. Iron is needed as a raw material for the production of hemoglobin, so you can only produce smaller red blood cells.

The three parameters of mean corpuscular volume (MCV), mean corpuscular hemoglobin content (MCH), and mean corpuscular hemoglobin concentration (MCHC) are collectively referred to as the three parameters of red blood cells. Basically, if it is the same person, the changes in these three parameters will not be very large. Of course, if it is a blood transfusion, it will increase, and of course RDW (red blood cell volume distribution width) will also increase!

A decrease in the three parameters is medically known as "microcytic hypochromic anemia". The most common clinical microcytic hypochromic anemia is iron deficiency anemia. Basically, it accounts for 90% of the proportion! RDW is basically <15%. I don’t know what your parameter of 38.6% means! And even if RDW increases after blood transfusion, it can’t be so high!

The most common cause of increased neutrophil percentage is inflammation, but some physiological reactions are also possible, such as stress, menstruation, etc.

In addition, anemia can be classified based on the values ​​of MCV and RDW.

1. MCV decreased and RDW normal: microcytic anemia. Common in thalassemia minor and chronic diseases.

2. MCV decreased and RDW increased: microcytic anemia. It is common in iron deficiency anemia, β-thalassemia, hemoglobin H disease, and hemoglobin S disease.

3. Normal MCV and normal RDW: normocytic homogeneous anemia. This is the case for normal people. Other abnormal manifestations may include chronic diseases, chronic liver disease, acute bleeding, chronic lymphocytic leukemia, chronic myeloid leukemia, and after chemotherapy.

4. Normal MCV and elevated RDW: normocytic heterogeneous anemia. Such as early or mixed nutritional deficiencies, anemia with abnormal hemoglobin, myelofibrosis, myelodysplasia, sideroblastic anemia, etc.

5. MCV increased, RDW normal: macrocytic homogeneous anemia. Such as aplastic anemia, preleukemia, elevated cold agglutinins, etc.

6. Increased MCV and RDW: macrocytic heterogeneous anemia. Such as megaloblastic anemia caused by folic acid or vitamin B12 deficiency, and some sickle cell anemia. In hemolytic anemia and megaloblastic anemia, MCV and red blood cell volume distribution width are increased.

"When the body is in a disease state, the concentrations of fibrinogen and globulin in plasma increase, red blood cell aggregation increases, and blood fluidity decreases, leading to ischemia and hypoxia of tissues or organs. The aggregation index is calculated by the ratio of low shear viscosity to high shear viscosity, and the representative symbol is RE.

RE = Low Shear Viscosity / High Shear Viscosity

It is an objective indicator reflecting the degree of red blood cell aggregation. An increase in RE indicates enhanced aggregation.

Red cell rigidity index

As the shear force on normal red blood cells in the blood increases, their deformation and orientation increase, and the apparent viscosity of the whole blood decreases. However, hardened red blood cells do not have this effect. The degree of red blood cell hardening increases or the deformability decreases, and the high shear relative viscosity of whole blood increases. Whole blood high shear viscosity is used to measure red blood cell deformability, and the more commonly used index is the red blood cell rigidity index (IR).

Where ηb is the high shear viscosity of whole blood, ηp is the plasma viscosity, and HCT is the hematocrit. The larger the red blood cell rigidity index IR is, the higher the degree of red blood cell hardening is and the worse the red blood cell deformability is.

Red cell deformability

Red blood cell deformability refers to the ability of red blood cells to change shape under the action of external forces during flow, which is an important rheological phenomenon. Red blood cell deformability is a key factor affecting the viscosity of whole blood under high shear rates.

Causes of low mean red blood cell count

A decrease in the average red blood cell volume is often seen in microcytic hypochromic anemia, which is often manifested as iron deficiency anemia and systemic hemolytic anemia.